Kicking the habit improves smokers’ arteries

Many who quit gain weight, but study shows they still see health benefit

A year after kicking the habit, smokers' arteries showed signs of reversing a problem that can set the stage for heart disease, according to the first big study to test this.

The improvement came even though smokers gained an average of 9 pounds after they quit, researchers found. Their levels of so-called good cholesterol improved, too. 

"A lot of people are afraid to quit smoking because they're afraid to gain weight," said the study's leader, Dr. James Stein, a University of Wisconsin-Madison cardiologist.

The new research shows these people gain a health benefit even though they pick up pounds that hopefully can be shed once they've gotten used to not smoking, he said.

Smoking is one of the top causes of heart disease, and about one third of smoking-related deaths in the U.S. are due to heart disease. A heart attack often motivates longtime smokers to give it up.

Quitting is known to lower the risk of developing or dying of lung cancer. This is the first major clinical trial to show it quickly improves artery health. Results were published in the Journal of the American College of Cardiology and presented at the group's annual conference on Monday.

In the study, 1,500 smokers were given one of five methods to help them quit — nicotine patches; nicotine lozenges; the drug bupropion, sold as Wellbutrin and Zyban; or a combination of patches and lozenges or the drug and lozenges. A sixth group received a dummy treatment.

After one year, 36 percent had quit, and it made no difference which method they used, Stein said.

Before the study started and one year after smokers quit, doctors did ultrasound tests to see how well blood vessel linings relaxed and handled blood flow. Hardening of the arteries is an early step to heart disease. Using a tourniquet, they stopped blood flow in the forearm for a few minutes, then measured how a major artery responded when the flow was restored.

"It's a valid test" and is considered a good sign of how healthy the heart arteries are, said Dr. Alfred Bove, a Temple University heart specialist and president of the cardiology group.

Doctors found that artery function improved 1 percent in the quitters.

"That may not sound like much," but research shows that translates to a 14 percent lower risk of developing heart disease, Stein said.

"It's a small improvement at one year. The question is, do these folks keep getting better?" Bove said.

The study is continuing another two years to give an answer, Stein said.

London-based GlaxoSmithKline PLC provided smoking cessation medicines for that part of the study, and several authors have research funding from the company. Federal government grants paid for the artery study.

 

Genes reveal 'biological ageing'

Gene variants that might show how fast people's bodies are actually ageing have been pinpointed by scientists.

Researchers from the University of Leicester and Kings College London say the finding could help spot people at higher risk of age-related illnesses.

People carrying the variant had differences in the "biological clock" within all their cells.

The British Heart Foundation said the findings could offer a clue to ways of preventing heart disease.

While doctors know that as people age they are more at risk from diseases such as Alzheimer's, Parkinson's and heart disease, some people fall prey to these at an earlier age than expected.

Telomeres

One theory suggests that biological timers called "telomeres", part of the chromosomes in every cell that carry genetic code, may be a factor in this.

From birth, every time a cell divides, the telomeres get shorter and there is some evidence that people with shorter telomeres, either because they diminish more quickly or because they were born with shorter versions, may be at higher risk from age-related illness.

The researchers say in the journal, Nature Genetics, that they looked at more than 500,000 genetic variations across the entire human genome to see which variants cropped up more frequently in people known to have shorter telomeres.

They eventually located a number of variants located near a gene called TERC which, in people carrying them, seemed to be equivalent to an extra three or four years of "biological ageing".

Bad lifestyles

Professor Tim Spector, from King's College London, said: "What our study suggests is that some people are genetically programmed to age at a faster rate.

"Alternatively, genetically susceptible people may age even faster when exposed to proven 'bad' environments for telomeres such as smoking, obesity or lack of exercise - and end up several years biologically older or succumbing to more age-related diseases."

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which part-funded the study, said it was not yet clear whether telomeres did contribute to an increased risk of disease.

He said: "Understanding how our cells age is an important step in our quest for better ways to prevent and treat heart disease.

"Perhaps in the future one of the ways we try to reduce the risk of, or treat, heart disease would be to use an 'anti-ageing' approach for our arteries."

Nano technology tackles heart disease

A molecule designed to find, latch onto, then treat hardened arteries could offer a new way to tackle heart disease, say its inventors.

Nanoburrs, developed at the Massachusetts Institute of Technology (MIT), target only damaged cells in blood vessel walls.                                                                   

Once attached, they can release drugs in precisely the right place.

But the British Heart Foundation warned the technology was some years from being used in patients.

The hardening of the arteries which supply the heart, or atherosclerosis, can eventually lead to blockages which can cause heart attacks.

The study in the Proceedings of the National Academy of Sciences journal says specialists normally use tiny balloons to force open the vessels, then place a tube called a stent inside to keep it open.

Often the process triggers a rapid re-growth of tissue around the stent which can lead to the artery blocking again, and a recent advance has been a stent which releases drugs for a number of days after insertion to keep this process under control.

The MIT approach offers another way to get these drugs to exactly the right place.

Its nanoburrs are coated with proteins which can only stick to a structure in the blood vessel wall called the "basement membrane".

This is only exposed when the wall is damaged, so only damaged sections of blood vessel are targeted.

Once in place, a reaction takes place to release the drug over a prolonged period - up to 12 days so far.

Long way off

Professor Robert Langer, one of the authors of the research, said: "This is a very exciting example of nanotechnology and cell targeting in action."

He said the technology could target any condition in which the cell wall was compromised in this way, including certain types of cancer, and other inflammatory diseases.

Professor Peter Weissberg, medical director of the British Heart Foundation, said that while the technology was "promising", there were many time-consuming obstacles to overcome before it could be regularly used in patients.

He said: "This is an interesting proof of principle. People have been looking for a long time for ways to target a particular drug to a particular part of the body.

"It wouldn't be able to replace the need for a balloon and stent to open an artery, but it's possible that one day, it may be able to deliver a drug to treat atherosclerosis itself."

No such thing as 'safe' cocaine, experts warn

The image of cocaine as a "safe party drug" is a myth that must be dispelled, say UK experts, as a study shows the drug is linked to 3% of sudden deaths.

The British Heart Foundation said the findings, published in the European Heart Journal, were a reminder that the drug can have devastating effects.

Although the data comes from south-west Spain, researchers said the results should apply to Europe in general.

They said anyone could suffer the deadly consequences of taking cocaine.

Fotini Rozakeas of the British Heart Foundation said: "The reality is that there are risks every time you use it.

"Cocaine can have devastating effects on the user including heart attacks, life-threatening heart rhythms, strokes and even sudden death.

"The potential deadly consequences from cocaine use can happen to anyone who takes it, even in previously young healthy people with no history of heart disease."

Deadly cocktail

In the study, 21 out of 668 sudden deaths were related to cocaine use and all of these occurred in men aged between 21 and 45.

Most involved problems with the heart and the majority of the men were also smokers and had been drinking alcohol at the same time as taking cocaine.

Lead researcher Dr Joaquin Lucena, of the Institute of Legal Medicine in Seville, said these habits added up to a lethal cocktail for the heart.

He said: "Our findings show that cocaine use causes adverse changes to the heart and arteries that then lead to sudden death."

His teams looked at post-mortem reports and investigated all the circumstances surrounding sudden deaths in Seville between 2003 and 2006.

Their findings suggested any amount of the drug could be toxic.

"Some patients have poor outcomes with relatively low blood concentrations, whereas others tolerate large quantities without consequences," they told the European Heart Journal.